Advancing the science of symptom management.

UNLABELLED Since the publication of the original Symptom Management Model (Larson et al. 1994), faculty and students at the University of California, San Francisco (UCSF) School of Nursing Centre for System Management have tested this model in research studies and expanded the model through collegial discussions and seminars. AIM In this paper, we describe the evidence-based revised conceptual model, the three dimensions of the model, and the areas where further research is needed. BACKGROUND/RATIONALE The experience of symptoms, minor to severe, prompts millions of patients to visit their healthcare providers each year. Symptoms not only create distress, but also disrupt social functioning. The management of symptoms and their resulting outcomes often become the responsibility of the patient and his or her family members. Healthcare providers have difficulty developing symptom management strategies that can be applied across acute and home-care settings because few models of symptom management have been tested empirically. To date, the majority of research on symptoms was directed toward studying a single symptom, such as pain or fatigue, or toward evaluating associated symptoms, such as depression and sleep disturbance. While this approach has advanced our understanding of some symptoms, we offer a generic symptom management model to provide direction for selecting clinical interventions, informing research, and bridging an array of symptoms associated with a variety of diseases and conditions. Finally, a broadly-based symptom management model allows the integration of science from other fields.

[1]  R. Whittemore,et al.  The Peer Advisor Experience Providing Social Support , 2000, Qualitative health research.

[2]  Kathryn A. Lee,et al.  Parity and Sleep Patterns During and After Pregnancy , 2000, Obstetrics and gynecology.

[3]  Kathryn A. Lee,et al.  Sleep Disturbances in Children With Human Immunodeficiency Virus Infection , 1999, Pediatrics.

[4]  C. Marmar,et al.  Sleep patterns of sheltered battered women. , 1999, Image--the journal of nursing scholarship.

[5]  J. Berg The perimenopausal transition of Filipino American midlife women: biopsychosociocultural dimensions. , 1999, Nursing research.

[6]  S. Paul,et al.  Risk factors for chemotherapy-induced oral mucositis: dental appliances, oral hygiene, previous oral lesions, and history of smoking. , 1999, Cancer investigation.

[7]  B. Stevens,et al.  The efficacy of developmentally sensitive interventions and sucrose for relieving procedural pain in very low birth weight neonates. , 1999, Nursing research.

[8]  D. Taylor,et al.  Symptom experience of Filipino American midlife women. , 1999, Menopause.

[9]  N. Facione,et al.  Narratives of breast symptom discovery and cancer diagnosis: psychologic risk for advanced cancer at diagnosis. , 1998, Cancer nursing.

[10]  Robert M. Anderson,et al.  Contrasting Patient and Practitioner Perspectives in Type 2 Diabetes Management , 1998, Western journal of nursing research.

[11]  G H Duncan,et al.  Stimulation of human thalamus for pain relief: possible modulatory circuits revealed by positron emission tomography. , 1998, Journal of neurophysiology.

[12]  Satoshi Minoshima,et al.  Gender differences in pain perception and patterns of cerebral activation during noxious heat stimulation in humans , 1998, Pain.

[13]  S. Rankin,et al.  Meeting the needs of unpartnered elders: a peer training program involving elders with myocardial infarction. , 1998, Progress in cardiovascular nursing.

[14]  S. Janson,et al.  Reasons for delay in seeking treatment for acute asthma: the patient's perspective. , 1998, The Journal of asthma : official journal of the Association for the Care of Asthma.

[15]  L. Franck,et al.  Measurement of neonatal responses to painful stimuli: a research review. , 1997, Journal of pain and symptom management.

[16]  S. Sidani,et al.  Evaluating Nursing Interventions: A Theory-Driven Approach , 1997 .

[17]  F. Suppe,et al.  The middle-range theory of unpleasant symptoms: an update. , 1997, ANS. Advances in nursing science.

[18]  B. Stevens,et al.  Experience in a neonatal intensive care unit affects pain response. , 1996, Pediatrics.

[19]  J. Levine,et al.  Kappa–opioids produce significantly greater analgesia in women than in men , 1996, Nature Medicine.

[20]  M. Dodd,et al.  RANDOMIZED CLINICAL TRIAL OF CHLORHEXIDINE VERSUS PLACEBO FOR PREVENTIONOF ORAL MUCOSITIS IN PATIENTS RECEIVING CHEMOTHERAPY , 1996 .

[21]  J. Golding,et al.  Sexual Assault History and Premenstrual Distress in Two General Population Samples , 1996 .

[22]  Kathryn A. Lee,et al.  Is There a Generic Midlife Woman? The Health and Symptom Experience of Employed Midlife Women , 1996 .

[23]  Dodd Mj,et al.  Women's narratives of helpseeking for breast cancer. , 1995 .

[24]  E. Larson Exclusion of certain groups from clinical research. , 1994, Image--the journal of nursing scholarship.

[25]  B. Given,et al.  Family and out-of-pocket costs for women with breast cancer. , 1994, Cancer practice.

[26]  F. Stancavage,et al.  A controlled trial of two forms of self-management education for adults with asthma. , 1993, The American journal of medicine.

[27]  B. Given,et al.  The cost of cancer home care to families , 1993, Cancer.

[28]  Kathryn A. Lee,et al.  Biopsychosocial Correlates of Perceived Perimenstrual Weight Gain , 1993 .

[29]  D. Turk,et al.  Neglected topics in the treatment of chronic pain patients — relapse, noncompliance, and adherence enhancement , 1991, Pain.

[30]  S. Rankin,et al.  Differences in recovery from cardiac surgery: a profile of male and female patients. , 1990, Heart & lung : the journal of critical care.

[31]  M. Hudes,et al.  The sensations of pulmonary dyspnea. , 1986, Nursing research.

[32]  D. Taylor,et al.  Peer support, PMS, and stress: a pilot study. , 1986, Health care for women international.

[33]  A. Strauss,et al.  Politics of pain management: Staff-patient interaction , 1977 .